Bernie Sanders’ Bill Would Make Painkiller Epidemic Worse

Canadian importation would spur boom in killer fentanyl.

She manages AAC Needle Exchange in Cambridge, Massachusetts, where she and her staff provide clean needles, packages of naloxone, a drug that reverses overdoses, and other needs for those addicted to hard drugs.

Sometimes, drug addicts receive their fresh needles and don’t even leave the office before locking themselves in the bathroom and shooting up. And as Hynes told NPR, some of them can’t make it to the door afterward.

“Recently we had a guy leave the bathroom, and all the color just drained from his face, like immediately, and he just turned blue,”Hynes said. “I’ve never seen anyone turn blue that fast. He was completely blue and he just fell down and was out—not breathing.”

When she bent down to try to pump his heart, she couldn’t. He had been hit with “wooden chest,” in which “your chest just seizes up,” Hynes said. “You literally have paralysis, and that’s obviously really dangerous, because if someone needs CPR, you can’t do it.”

The wooden chest spread, and soon the man also had lockjaw. His mouth would open but only a tiny bit, which meant Hynes could barely even help with rescue breathing.

Hynes did succeed, and the man did survive. But across the United States, junkies are dying because the drugs they’re buying on the street are not what they think they are.

Increasingly, they are laced—or even promiscuously mixed with—fentanyl, a painkiller 50-100 times more powerful than heroin. Police nationwide say people are buying what they think is heroin or oxycontin. But with fentanyl mixed in, the drugs are much more powerful than users anticipate, and many aren’t ready.

Hynes tells her clients to stick with dealers they know, and always use with a buddy because the overdoses come so quickly.

It is the fentanyl that caused the man in Hynes’ office to collapse instantly and for his chest to seize up and almost prevent his rescue.

And it is fentanyl that is changing the complexion of emergency room overdose treatment nationwide. Fentanyl deaths climbed more than 400 percent inPhiladelphia from 2014 to 2015. They climbed nearly 700 percent in the two years from 2014 to 2016. Four people died from fentanyl overdoses in Cincinnati in 2013. In 2014, the total was 124.

Bernie Sanders, the socialist senator from neighboring Vermont, which has had its own fentanyl problems, has proposed legislation that could cause the amount of this extremely dangerous drug to grow exponentially on America’s streets—all so he could fashion himself the enemy of drug manufacturers.

Sanders’ legislation would make it legal for Americans to order prescription drugs from pharmacists outside the country. It is sold as a cost-cutting measure—on the theory competition from foreign pharmacies would bring down prices.

But most who have studied the issue say it brings little in the way of real savings, and what little savings does occur must be weighed against broad new challenges to the security of the supply chain for prescription drugs in the United States.

As Leona Aglukkaq, former health minister of Canada,has pointed out, a recent study by the U.S. Food and Drug Administration found 85 percent of the drugs supposedly imported from Canada did not in fact come from there, but rather 27 other countries.

Moreover, fentanyl is made in Mexico and China, and neither Canada nor the United States has the resources to make sure drugs exported from those nations match their labels.

Derek Arnson, former police chief in Nogales, Ariz., on the Mexican border, said Sanders’ bill would encourage a boom in fentanyl production drug cartel-plagued Mexico and thus “vastly increase the flow of illegal narcotics and counterfeit drugs laced with fentanyl into the United States.”

Moreover, drug companies won’t take this lying down—they can limit sales of drugs to countries, such as Canada, that would be likely to export drugs to the United States, and can respond by limiting the sale of drugs in certain countries known for exporting to the United States, such as Canada, creating shortages in those countries.

“The rising prices for drugs are not sustainable in this country, and there’s a major concern for affordability,” Joshua Sharfstein, a former deputy commissioner at the FDA now at the Johns Hopkins Bloomberg for Public Health told theWashington Post. “That’s why people are seriously considering these sorts of solutions.

“But I’d like to think we could have a more rational approach that doesn’t require what is, in effect, a massive workaround.”

An unintended consequence of Sen. Sanders’ idea is that some people will use this system to drive to Canada to fill “prescriptions” for fentanyl to mix with illegal drugs. When politicians pitch the cost savings for consumers of importing drugs from other countries, they tend to gloss over the serious consequences of a major policy change.

Brian McNicoll, former senior writer for The Heritage Foundation and director of communications for the House Committee on Oversight and Government Reform, is a conservative columnist based in Reston, Virginia.

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I don’t think anyone crossing the border with a fentanyl prescription will be welcomed in Canada, we have strict rules surrounding narcotics, fentanyl is only available as a patch here as well. Bernie Sander’s bill would more realistically allow asthma patients access to affordable medication and cardiovascular patients would have more options. The drugs companies shouldn’t be charging multiples more for the same thing in the US when the USD is so strong.

Until the US got the Chinese government to crack down on Carefentanyl a few months ago, the price delivered to the US through the mail was 10,000,000 doses. Note that this is far more toxic than VX nerve gas). I would assume a production cost in volume of < $4/gram.

Fentanyl is not particularly toxic when used at recommended dosages – it is an effective narcotic and is typically used for colonoscopies combined with a memory blocker.

The problem is that fentanyl and its derivatives are not appropriately diluted before use – and the illegal drug market structure is not likely to do so.

The last I saw, the worldwide production of opium is <10,000 tons, yielding ~1000 tons of heroin. From what I understand, law enforcement interdicted < 50% of the supply. There is no hope in interdicting fentanyl and its more potent analogues. A few grams in an envelope are ~ 1,000,000 doses.

I am expecting a wholesale shift to the synthetic narcotics (I have been expecting this for the past few decades, it has taken longer than I expected.), which will put the opium growers out of business. But societies are going to have to move to damage mitigation approaches, not fruitlessly attempt to interdict supply. We failed with heroin and cocaine, and have far less hope with drugs that are far more potent and involve smuggling far smaller quantities.

Really?!?! This is what free market conservatives believe???? Expensive Pharma Drugs are good for us in the USA????

Considering Painkillers are only a small percentage of drugs, this argument make the Heritage Foundation look paid Big Pharma lap dogs. I think awful that the US consumer has to overpay for drugs just so other nations can pay less. And leave to the socialist to promote free trade benefits in the pharma drugs.

I say if we both allow foreign approvals for sale, then the US consumer can buy from that nation.

So why do I have to pay more for something because somebody else might abuse it? It seems to be the same logic as “Why should I have my access to firearms restricted/limited because somebody else abused that right?”

Desperate druggies always get whatever mind-altering / life-destroying substance they want one way or another. I hope Bernie’s bill passes, and I hope that no loopholes are left in for the Healthcare/Pharmacy/Insurance cartel to lobby and ruin the bill. As for keeping people off a drugs, I am doing that by parenting. If I had to depend on the government’s unwinnable War on Drugs to keep my kids safe then they would probably end up being full-fledged junkies.

Given the prevalence of illicit fentanyl in Canada, getting a prescription for it is hardly the easiest or most efficient way for an American citizen to obtain it. The export of fentanyl, and its trafficking, are illegal under Canadian law.

An unintended consequence of Sen. Sanders’ idea is that some people will use this system to drive to Canada to fill “prescriptions” for fentanyl to mix with illegal drugs.

That is apparently the best the author can do in terms of constructing an actual mechanism that would “cause the amount of this extremely dangerous drug to grow exponentially on America’s streets.” Given that both Canada and the US are awash in illegal fentanyl already, that’s pretty weak tea.

A shockingly silly argument. The genesis of the opioid crisis was overprescription of oxycontin. That is a US PhRMA and doctor problem. But it is actually bigger than just that. There are work and health and cultural issues that play into the rapid rise of opioid addiction. Look at the epidemiology of where and why those drugs are over-prescribed.
Fentanyl is now supplied through both legal and illegal sources, with illegal sources on the rise as more scrutiny is applied to legal sources.
The idea that importing drugs from Canada would allow greater access to fentanyl or other opioids is not supported by logic or fact.